Question

compare and contrast the various roles of the registered nurse in the preoperative area, operating room, and PACU. Base your information provided in this section on the observations you made while in each unit. Please be reflective and cover all areas of the nurses’ responsibilities. You should utilize a paragraph per area you are discussing.

subject: Total knee replacement

Answer 1

#. Preperative nursing responsibilities :-

Complete:-

Nursing history

Health history

Client knowledge/understanding of the surgery

Physical assessment

Focus on symptoms that indicate risk for surgery

Preoperative screening tests :-

CBC

Urinalysis

ECG

Surgical consent

Confirm its presence

Complete preoperative teaching

Discussion

Printed materials

Procedure

Post-procedure process: home vs. hospitalization

Turning, coughing, deep breathing

Preparing the client physically

Assess NPO status

Prepare skin: surgical scrub

Bowel preparation

Facilitate an empty bladder

Administer preoperative medications

Apply antiembolism stockings

#. Intraoperative Care include :-

#. As a holding area nurse:-

deals w/ Physical preparation

-starts IV

-monitors pulse ox, EEG for sedation level and EKG, HR, BP

-gives Preoperative medications- Antibiotics, Anti-emetics

-Review preoperative checklist

-Verify consent is complete

As a circulating nurse :-

-sets up OR the way the surgeon likes

-must remain 3 ft away

-Oversee pt nursing care in the OR

-Make OR safe and functional

-Set up OR bed- positioning aids, straps, heating equipment, grounding of electrical equipment

-Responsible for positioning of pt during sx

-Assist positioning during induction/intubation

-Completes OR documentation

-Notifies PACU of anticipated pt arrival

As a scrub nurse :-

a sterile assistant in surgery- aka surgical technologist

-Set up sterile table

-Drape patient

-Hand sterile supplies to surgeon or surgeon's assistant

-Along with Circulation Nurse, maintains accurate count of sponges, sharps, instruments and amounts of irrigation fluid used.

#. PACU nursing responsibilities :-

Recovery from anesthesia

Airway management

Vital signs/level of consciousness

Dressing assessment/drainage

Fluid therapy

Pain control

Postoperative Care: Nursing Unit :-

Initial physical assessment

Frequent vital signs

Dressing management

Pain control

DVT prevention - SCDs

Incentive spirometry/ cough and deep breathing

Early ambulation

Client teaching